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Helping individuals with firearm injuries: A cluster randomized trial.

Vivian H Lyons¹, Anthony S Floyd, Elizabeth Griffin

¹From the Department of Health Behavior and Health Education (V.H.L.), University of Michigan, Ann Arbor, Michigan; Department of Epidemiology (V.H.L., E.G., A.H., F.P.R., A.R.-R.), School of Public Health, Firearm Injury and Policy Research Program, Harborview Injury Prevention and Research Center (V.H.L., A.S.F., J.W., L.K.W., K.P.H., F.P.R., A.R.-R.), Alcohol and Drug Abuse Institute (A.S.F.), and Department of Biostatistics (M.C.), University of Washington, Seattle, Washington; Department of Biostatistics and Bioinformatics (D.B.), Emory University, Atlanta, Georgia; Department of Emergency Medicine (L.K.W.), School of Social Work (K.P.H.), Social Development Research Group (K.P.H.), and Department of Pediatrics (F.P.R.), School of Medicine, University of Washington, Seattle, Washington.

The Journal of Trauma and Acute Care Surgery

|January 6, 2021

Summary

A hospital and community intervention did not reduce arrests or injuries in firearm injury patients. This low-intensity program showed no significant association with reduced risk of subsequent arrest or injury.

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Area of Science:

Public Health
Trauma Surgery
Criminology

Background:

Patients with firearm injuries face high risks of re-injury and arrest post-discharge.
A joint hospital- and community-based intervention was designed to mitigate these risks.

Purpose of the Study:

To evaluate the effectiveness of a 6-month low-intensity intervention on reducing subsequent arrest and injury risks.
To assess the impact of a multi-agency support program for firearm injury survivors.

Main Methods:

A cluster randomized controlled trial was conducted at a level 1 trauma center.
The intervention included hospital-based motivational interviewing and 6-month community support.
Outcomes measured were subsequent arrest risk and risk of death or injury requiring medical treatment.

Main Results:

Intervention assignment or engagement did not significantly alter the risk of arrest at 2 years post-discharge.
No association was found between the intervention and the risk of subsequent injury.
Relative risk for intervention assignment was 1.15 (95% CI, 0.90-1.48).

Conclusions:

The joint hospital- and community-based intervention did not demonstrate a significant effect on reducing arrest or injury risks.
The lack of observed effect may be attributed to the low intensity of the intervention program.
Further research into more intensive interventions for firearm injury survivors is warranted.